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Ethics Rules, Ethic Dilemma, Principal of Profesionalism: Rsud Sidoarjo I2
Ethics Rules, Ethic Dilemma, Principal of Profesionalism: Rsud Sidoarjo I2
5. Responsible √
7. Limitation of Goal-Based √
Criteria Yes No
Beneficence
Autonomy
PRIMA FACIE :
AUTONOMY
BENEFICENCE
• The patient still treated in NICU and the
doctor suggested referring to a better
hospital because the condition was harmful.
AUTONOMY
• The father intended to not refer his child
because economy factors and bad condition
of his wife. So, the doctor giving the father
time to consider it
4 BOX METHOD OF CLINICAL ETHICS
Medical Indication Client Preferences
• The condition was harmful. • The patient cannot make a
• The patient need to be referred decision. His father is in represent
for better treatment because his for making a decision.
hydrocephalus and brain damage.
• If his father refused, the patient
still treated at the NICU with the
possibility getting worst condition.
Quality of Life Contextual Features
• In the NICU, the patient possibility Social and economic condition affect
getting worst condition. the father for making decision to
• If the patient can be saved, maybe refer his child to the better hospital.
have brain damage and it will
affect to his motoric system.
PRINSIP PROFESIONALISME
1. Alturism (+) : the doctor suggested referring to a
better hospital because the patient condition was
harmful and risked brain damage.
2. Accountability (+) : the doctor is full of
responsibility for patient safety
3. Duty (+) : the doctor very responsive about that
his patient need better treatment at the time.
4. Respect for others (+): respect the opinion of the
patient’s father and wait patiently for the
decision.
5. Humanity (+) : the doctor have empaty for the
economic condition of patient’s family.
Extra-ordinary Treatment
• Because in this case the treatment of the patient
need more cost such as for transportation, cost of
living, and cost for NICU maintenance. And the
patient need special care to save his life.
CASE 2
Case
A 58 years old woman came to emergency room with
pain in her upper abdominal and chest accompanied
by nausea, vomiting, excessive sweating, and
trembling. The woman has a history of hypertension.
So, the doctor in ER diagnose the patient suspect
coronary heart disease and recommend
hospitalization. After being given medication the
patient has hypotension. Finally, this patient is
treated by cardiologist. Cardiologist performs
advanced ecocardiography examination to preserve.
Cardiologist say that the patient’s heart condition is
okay. The patient only has an attack of chronic
gastritis.
BENEFICENCE
CRITERIA YES NO
5. Responsible √
7. Limitation of Goal-Based √
Criteria Yes No
Beneficence Non-
Maleficence
PRIMA FACIE :
NON-MALEFICENCE
BENEFICENCE
• The doctor at emergency room try to provide
the best tharepy according to their abilities.
But, the therapy was not succesful so the
doctor was consulted to the cardiologist.
NON-MALEFICENCE
• The doctor may be less careful in examining
so that the diagnosis is wrong and it can
endanger the patient.
4 BOX METHOD OF CLINICAL ETHICS
Medical Indication Client Preferences
• The patient diagnosed with • The patient can make decision for
suspected coronary hearth her treatment including agree to
disease with doctor at emergency be examined by cardiologist.
room
• After give some drug, the patient
have hypotension
• And then, cardiologist checks and
diagnose with chronis gastriris.
Quality of Life Contextual Features
• The patient looks uncomfortable Social and economic condition,
due to the pain. religion and cultural factors cot affect
• After give some drug, the patient the patient to make decision.
feeling dizzy and weak.
PRINSIP PROFESIONALISME
1. Alturism (+) : the doctor was consulted to
cardiologist because he feel his theraphy is
incorrect.
2. Accountability (+) : the doctor is full of
responsibility for patient safety
3. Duty (+) : the doctor very responsive when
patient need some help at emergency room
4. Humanity (-) : the doctor make a mistake in
diagnosis because it is less thorough
• This case is extra-ordinary treatment
Thank
you